Appropriateness of antimicrobial therapy measured by repeated prevalence surveys

被引:117
作者
Willemsen, Ina
Groenhuijzen, Anneke
Bogaers, Diana
Stuurman, Arie
van Keulen, Peter
Kluytmans, Jan
机构
[1] Amphia Hosp, Lab Microbiol & Infect Control, NL-4800 RK Breda, Netherlands
[2] Franciscus Hosp, Dept Pharm, Roosendaal, Netherlands
[3] Amphia Hosp, Dept Pharm, Breda, Netherlands
关键词
D O I
10.1128/AAC.00994-06
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Prudent use of antibiotics is mandatory to control antibiotic resistance. The objective of this study was to determine if prevalence surveys are useful tools to determine the appropriateness of antimicrobial therapy (AMT) and determinants of inappropriate AMT. The study was performed in a 1,350-bed teaching hospital including all medical specialities. Six consecutive 1-day prevalence surveys of in-patients were performed twice yearly from 2001 to 2004. Data on the demographics, infections, and AMT were gathered. The appropriateness of AMT was assessed according to a standardized algorithm based on the local AMT prescription guidelines. On average, 684 patients were included in each survey (total, 4,105). The use of AMT as determined in the prevalence survey corresponded to the annual data from the pharmacy department. Nine hundred thirty-eight (22.9%) of the patients received AMT, and in 351 (37.4%) of these patients AMT was inappropriate. Only 25 (0.6%) patients did not receive AMT, although it was indicated. After multivariate analysis, the use of quinolones was the only statistically significant variable associated with inappropriate use. Prevalence surveys proved to be useful tools to judge the appropriateness of AMT and to identify determinants of inappropriate use. This study shows that in a setting with a low use of AMT, there are few patients who inadvertently do not receive AMT. On the other hand, a substantial number of the patients are treated inappropriate.
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页码:864 / 867
页数:4
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